For My Fellow Fat Therapists

In a time where everyone is pursuing weight loss again, it’s hard to do this work.

I’m writing this for my fellow fat folks, especially my fellow fat therapists. You’re not alone in resisting the intense wave of weight loss talk. It’s feeling extra lonely for those of us that remain fat, and those of us that are intentionally working towards fat acceptance and fat liberation. 

Therapy clients feeling ambivalent about their own body acceptance is not new for me. The whole time I’ve done this work, I’ve faced clients who decide to pursue intentional weight loss no matter what healing work we’ve done or what they’ve learned about weight loss research. I literally had a client seek out working with me, and then in the first session announce she had liposuction a few days ago. The ambivalence is real, and I get it. I’ve had clients on GLP-1s for a long time, almost all who have insulin related conditions and for whom the medication is working as intended (weight loss or no weight loss). 

But, in the last three months in particular, I’ve had a wave of clients more intentionally choosing weight loss than I’ve seen so far in my career. For instance, I’ve had a long standing client who has decided to take GLP-1 medication because she was done resisting the temptation (her words). I’ve had a client begin the process for weight loss surgery. Both have eating disorder histories. I’ve had two clients who have always been in thin bodies, and are still in thin bodies, argue with me about anti-diet research while acknowledging they miss no longer being on the top of the body hierarchy in their minds. All of this is to say that the last three months have been really hard for me as a therapist. 

I’ve had to stay firm in my commitment to fat liberation while balancing clients’ body autonomy. I’ve had to offer neutral exploration of their goals in pursuing weight loss while reality checking what actually happens on these meds or after surgery. And I’ve had to listen to a lot of anti-fat sentiment while being fat myself. My fat body is visible to them as they say these things. It sucks. Plain and simple. It hurts. It makes me less comfortable to be in session with them, especially when it’s a thin client who is explicitly telling me what fat people have always known- thin people are comparing their bodies to our fat bodies, and feeling superior to us. They are indeed seeing themselves as better and more worthy. We’ve known this to be true, but here is a client telling it directly to my fat face. Yes, they’re not making it specifically about me. But it is still specifically about me. 

Of course clients are supposed to share their fears and their internal belief systems. This is often a part of the work I do with clients around body acceptance. We do intentionally look at their anti-fatness and where it comes from and we examine it. With clients who are in larger bodies, this is usually a conversation that holds real pain and experiences of being wounded throughout their life. It’s very easy to feel compassion and care; here’s a place of shame for us to heal. With thin clients though, it can sometimes become an intellectual argument. They don’t get that their internalized ant-ifatness hurts them, and they don’t always actually care that it hurts others. This is not the case with all my thin clients, but with some of them this has been true. I’m then in the position of presenting research, trying to make the case that fat people are just as worthy, and their thinness does not assign them value or goodness. They usually have a hard time understanding this, and some have outright argued that people do have inherent differences in their worthiness. (Those clients usually don’t last too long with me…) 

I’m sharing this because I want other fat therapists to not feel alone in the hurt they experience through helping others heal. And I’m sharing this because I want thin people, therapists or otherwise, to look at their behavior and their belief systems.

I know this work is hard, and I’ve always known there is risk for vicarious trauma, etc, in this work. But it’s another thing to be told directly to my face why I’m less valuable, why my body is bad and undeserving. To have to hold that and to still in that moment, turn my care and attention towards the person hurting me. To put myself aside when I’m being insulted, however indirectly they intend the insult, and to care about the one doing the harm. It can’t be about me in that moment, and I’m tasked with seeing their pain underneath the pain they are causing.

This is the emotional labor so many people in marginalized bodies are doing all day, every day. I know there are generations of people who have had to do this to keep themselves safe, or because it is literally their job. How many black people have had to tend to white tears instead of their own? 

I hate that this is my job sometimes. 

Writing this is part of how I’m helping myself recover from these sessions. I’m grateful to have a consultation group specially for fat therapists where my feelings and needs were validated. I’m grateful for fat community where I can exist in my body comfortably and safely. I’m grateful for years of work on my own body acceptance that has me committed to caring for myself, feeding myself, moving my body, and loving myself without conditions. 

I’m curious to hear how other fat therapists are handling these kinds of conversations and if others are finding ways during sessions to care for themselves or even speak up. I work hard to balance client’s needs with respect for myself. In this way, this job is complicated and I’m not sure what the right answer is. I welcome opinions from other therapists who have been in similar positions.

And to all my other fat therapists, I’m with you. You don’t deserve to be hurt in the course of your work, and also, this is sometimes the nature of the work. May you hold yourself gently as I try to do the same.